A simple mouthwash rinse may be able to predict the dangerous recurrence of a kind of throat cancer that is rapidly increasing in heterosexual men, according to a new study.
The cancers, which occur mostly among men who give women oral sex, are caused by human papilloma viruses, or HPV.
Papilloma viruses, which are also spread through genital sex, have become the leading cause of oropharyngeal cancer in the United States, as smoking has declined and men have become more willing to perform cunnilingus.
Unlike most sexually transmitted infections, the cancer is much less common in gay men; doctors believe the virus survives longer in vaginal fluid than on the penis.
Oropharyngeal cancer has been found to be increasing elsewhere, mostly among young men in wealthy countries, including Australia, Britain, Canada and Japan.
The study, published recently in JAMA Oncology, was small, involving 67 patients who had had cancer surgery. After surgery, only five of the 67 still had oral infections with HPV Type 16, detected in mouthwash rinses several months later. All five developed recurrences of the cancer, and three died of it.
The virus was found in the mouthwash months before the recurrences caused other detectable symptoms, said the lead author, Gypsyamber D’Souza, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health.
The cancers, which are usually diagnosed visually by means of a scope, are hard to see because they occur in the base of the tongue or deep in the folds of the tonsils. Mouthwash rinses are not good for initial screening, because only about half of all cancer victims ever have viral DNA in their rinse samples, even before diagnosis.
The symptoms that lead to most oropharyngeal cancer diagnoses are lumps in the throat, hoarseness when speaking and ear pain.
If tumors are found before they spread elsewhere, surgery is often successful.
--2015 New York Times News Service
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